Objective: This study aimed to evaluate the efficacy and safety of half-saline (HS) serum as an irrigation solution in chronic subdural hematoma (CSDH) surgery using the burr hole craniostomy (BHC) technique. Methods: This randomized clinical trial was conducted in university hospital referral centers from 2020 to 2021. Sixty-three patients with CSDH eligible for BHC were primarily enrolled. Two patients were excluded because of concurrent stroke. Sixty-one patients were randomly allocated into case (HS=30) and control (normal-saline [NS]=31) groups. HS was used to irrigate the hematoma in the case group and NS was used in the control group. The patients were followed-up. Clinical variables including demographic and medical findings, postoperative computed tomography findings, postoperative complications, hospitalization period, recurrence rate, and functional status measured by the Barthel type B index were recorded. Results: Forty-six of 61 patients were male (75.4%), and the patients’ mean age was 65.4±16.9 years, with equal distribution between the 2 groups. Postoperative effusion and postoperative hospital stay duration were significantly lower in the HS group than in the NS group (p=0.002 and 0.033, respectively). The postoperative recurrence within 3 months in both groups was approximately equal (6.6%). In terms of functional outcomes and postoperative complications, HS showed similar results to those of NS. Conclusion HS as an irrigation fluid in BHC effectively reduced postoperative effusion and hospital stay duration without considerable complications.

Objective: To determine the global level of knowledge, attitudes, and practices towards dengue fever among the general population. Methods: To complete this systematic review and meta-analysis, a thorough search for pertinent English-language literature was undertaken during the study's extension until October 2023. The search used Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest. A quality assessment checklist developed using a modified Newcastle- Ottawa Scale for the cross-sectional study was used to evaluate the risk of bias in the included papers. Inverse variance and Cochran Q statistics were employed in the STATA software version 14 to assess study heterogeneity. When there was heterogeneity, the Dersimonian and Liard random-effects models were used. Results: 59 Studies totaling 87 353 participants were included in this meta-analysis. These investigations included 86 278 participants in 55 studies on knowledge, 20 196 in 33 studies on attitudes, and 74 881 in 29 studies on practices. The pooled estimates for sufficient knowledge, positive attitudes, and dengue fever preventive behaviors among the general population were determined as 40.1% (95% CI 33.8%-46.5%), 46.8% (95% CI 35.8%-58.9%), and 38.3% (95% CI 28.4%-48.2%), respectively. Europe exhibits the highest knowledge level at 63.5%, and Africa shows the lowest at 20.3%. Positive attitudes are most prevalent in the Eastern Mediterranean (54.1%) and Southeast Asia (53.6%), contrasting sharply with the Americas, where attitudes are notably lower at 9.05%. Regarding preventive behaviors, the Americas demonstrate a prevalence of 12.1%, Southeast Asia at 28.1%, Western Pacific at 49.6%, Eastern Mediterranean at 44.8%, and Africa at 47.4%. Conclusions: Regional disparities about the knowledge, attitude and preventive bahaviors are evident with Europe exhibiting the highest knowledge level while Africa has the lowest. These findings emphasize the importance of targeted public health interventions tailored to regional contexts, highlighting the need for regionspecific strategies to enhance dengue-related knowledge and encourage positive attitudes and preventive behaviors.

OBJECTIVEThis research analyzes data on road traffic accidents (RTA) in Fars province, whose roads are among the highly dangerous ones in Iran. It investigates educational level and age involved in RTA in order to discover patterns that can prevent or decrease accidents.

METHODSThis research made use of data visualization techniques to find hidden patterns. The data included mortality rate related to RTA in Fars province and were obtained from Fars Forensic Medicine Registry covering a period of 1 year from March 21, 2010 to March 21, 2011. All data were analyzed using SPSS 11.5. The results were reported as descriptive indices such as frequency (percentage). The Chi-square test was applied to the data concerning educational level and age. P value less than 0.05 was considered significant.

RESULTSIn the mentioned period, 1 831 people were killed, out of whom un/lowly educated people (69.6%) accounted for the highest mortality rate. The significant relationship between educational level and mortality rate was found (X2 equal to 275.98, P less than 0.0001).Also three was a significant association between age and mortality rate (X2 equal to 371.20, P less than 0.0001). Young people (age between 20 and 29 years) contribute to higher RTA mortality rate compared with other age groups.

CONCLUSIONThe educational level and age are significantly correlated to mortality rate. The youth and un/lowly educated people suffer more fatal RTA.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Age Factors ; Aged ; Child ; Educational Status ; Humans ; Iran ; Male ; Middle Aged

Background: This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region.Main text We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane’s CENTRAL, as well as gray literature sources and manual searches of notable journals.The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case–control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome.Heterogeneity was evaluated using Cochran’s Q test and the I 2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. Conclusions Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.

Nervous system infections are among the most important diseases in travellers. Healthy travellers might be exposed to infectious agents of central nervous system, which may require in-patient care. Progressive course is not uncommon in this family of disorders and requires swift diagnosis. An overview of the available evidence in the field is, therefore, urgent to pave the way to increase the awareness of travel-medicine practitioners and highlights dark areas for future research. In November 2013, data were collected from PubMed, Scopus, and Web of Knowledge (1980 to 2013) including books, reviews, and peer-reviewed literature. Works pertained to pre-travel care, interventions, vaccinations related neurological infections were retrieved. Here we provide information on pre-travel care, vaccination, chronic nervous system disorders, and post-travel complications. Recommendations with regard to knowledge gaps, and state-of-the-art research are made. Given an increasing number of international travellers, novel dynamic ways are available for physicians to monitor spread of central nervous system infections. Newer research has made great progresses in developing newer medications, detecting the spread of infections and the public awareness. Despite an ongoing scientific discussion in the field of travel medicine, further research is required for vaccine development, state-of-the-art laboratory tests, and genetic engineering of vectors.

Nervous system infections are among the most important diseases in travellers. Healthy travellers might be exposed to infectious agents of central nervous system, which may require in-patient care. Progressive course is not uncommon in this family of disorders and requires swift diagnosis. An overview of the available evidence in the field is, therefore, urgent to pave the way to increase the awareness of travel-medicine practitioners and highlights dark areas for future research. In November 2013, data were collected from PubMed, Scopus, and Web of Knowledge (1980 to 2013) including books, reviews, and peer-reviewed literature. Works pertained to pre-travel care, interventions, vaccinations related neurological infections were retrieved. Here we provide information on pre-travel care, vaccination, chronic nervous system disorders, and post-travel complications. Recommendations with regard to knowledge gaps, and state-of-the-art research are made. Given an increasing number of international travellers, novel dynamic ways are available for physicians to monitor spread of central nervous system infections. Newer research has made great progresses in developing newer medications, detecting the spread of infections and the public awareness. Despite an ongoing scientific discussion in the field of travel medicine, further research is required for vaccine development, state-of-the-art laboratory tests, and genetic engineering of vectors.

Periconceptional care such as lifestyle plays an important impact role in offspring health. The aim of the present study was to clarify the perspective of Avicenna on periconceptional care. Avicenna (980-1037 A.D.) was one of the outstanding Persian physicians, who made great contributions to the field of medical sciences, in particular, obstetrics. In advance, Avicenna's book, Canon of Medicine, was considered to find his perspectives on periconceptional care. Then, his ideas and theories were compared to the current findings by searching the keywords in main indexing systems including PubMed/MEDLINE, Scopus and Institute for Scientific Information Web of Science as well as the search engine of Google Scholar. Current investigations show that gamete quality, pregnancy outcome, and offspring health at birth and long term depend on both parents' lifestyle in pre- and periconceptional period, as well as the intrauterine environment. Avicenna believed that seminal fluid, sperm, ovum, and developing conditions in utero were influenced by the stages of food digestion and the function of some organs. On the other hand, food digestion and function of the organs also depend on each parent's lifestyle and environmental factors. He mentioned 6 principles of healthy lifestyle: exercise, nutrition, sleep and awareness, excretion of body wastes and retention of necessary materials, psychic features, as well as air and climate. Thus, a multicomponent healthy lifestyle should be considered by parents of child-bearing age in an appropriate period before and in early pregnancy as well as elimination of any disorders in parents, to give birth to more healthy offspring.

Introduction: Lower extremity vascular injury can result in either temporary or permanent disability. Methods: This is a clinical audit involving all patients admitted to our institution from January 2008 to June 2018 of those who had undergone revascularization surgery for lower limb trauma. Results: Fifty-nine patients were in this study with a mean age of 28.1 years. Most of the patients were motorcyclist involved in road traffic accidents with cars (n=30, 50.8%). The popliteal artery was most commonly seen injury (n=41, 69.5%). The mean duration of ischaemia was 14.1 hours. The limb salvage rate was 89.8%. Conclusion: Lower extremity vascular injury caused by RTA treated in our institution predominantly involved young patients aged between 18–30 years associated with long bone fractures causing contusion and thrombosis of the popliteal artery.

BACKGROUND: The use of traditional and complementary medicine (T&CM) is increasing in both developed and developing countries. The school of Persian medicine (PM) in Iran is a comprehensive medical school that is rich in history and has its own special principles, elements, philosophy, and diagnostic and treatment options. Many complementary therapy modalities are also popular and in demand among patients and physicians. The aim of this paper is to provide logic for the policymakers in Iranian medical education to make changes in medical education curricula, particularly on integrating T&CM. METHODS: We reviewed the global experience in teaching T&CM to medical students, and highlighting the strengths of PM, described why it is necessary to integrate T&CM into general medicine curricula in Iran. RESULTS: PM is a traditional system of medicine that dates back about 7000 years. Although there are few studies about the safety and effectiveness of PM, research into it has recently been accelerated. There is a suitable opportunity for integrating T&CM with conventional medicine. Physicians should be familiar with T&CM to avoid any contraindications, interactions, and unwanted effects. CONCLUSION Traditional medicine is part of Iran's heritage and, thus, needs special attention. Familiarization of physicians with T&CM can help them choose the best treatment options for their patients. To integrate T&CM into the medical education curricula of Iran, a two-credit course has been proposed for implementation across the country.

OBJECTIVE: To explore potential natural products against severe acute respiratory syndrome coronavirus (SARS-CoV-2) via the study of structural and non-structural proteins of human coronaviruses. METHODS: In this study, we performed an in-silico survey of 25 potential natural compounds acting against SARS-CoV-2. Molecular docking studies were carried out using compounds against 3-chymotrypsin-like protease (3CL^PRO), papain-like protease (PL^PRO), RNA-dependent RNA polymerase (RdRp), non-structural protein (nsp), human angiotensin converting enzyme 2 receptor (hACE2R), spike glycoprotein (S protein), abelson murine leukemia viral oncogene homolog 1 (ABL1), calcineurin-nuclear factor of activated T-cells (NFAT) and transmembrane protease serine 2. RESULTS: Among the screened compounds, amentoflavone showed the best binding affinity with the 3CL^PRO, RdRp, nsp13, nsp15, hACE2R. ABL1 and calcineurin-NFAT; berbamine with hACE2R and ABL1; cepharanthine with nsp10, nsp14, nsp16, S protein and ABL1; glucogallin with nsp15; and papyriflavonol A with PL^PRO protein. Other good interacting compounds were juglanin, betulinic acid, betulonic acid, broussooflavan A, tomentin A, B and E, 7-methoxycryptopleurine, aloe emodin, quercetin, tanshinone I, tylophorine and furruginol, which also showed excellent binding affinity towards a number of target proteins. Most of these compounds showed better binding affinities towards the target proteins than the standard drugs used in this study. CONCLUSION Natural products or their derivatives may be one of the potential targets to fight against SARS-CoV-2.
Animals ; Antiviral Agents/therapeutic use* ; Biological Products/pharmacology* ; COVID-19/drug therapy* ; Humans ; Mice ; Molecular Docking Simulation ; SARS-CoV-2